National Review of Nursing Education
Multicultural Nursing Education
- 2. Aims
- 3. Method
2. Aims
The aims of the project are to:
- Explore the assumptions and concepts about nursing education within the context of multicultural health
- Map the ways in which Australian nursing education addresses (or fails to address) multicultural health, with a view to
- Recommending strategies for enhancing cultural competence in nursing within the Australian healthcare system.
These aims are achieved by:
- Exploring the meanings and the implications of culture and diversity among the key stakeholders in Australian nurse education
- Identifying educational approaches towards diversity that are currently offered to undergraduate and postgraduate nursing students
- Defining the spectrum of cultural competence across nursing education programs at the individual, professional, organisational and system levels within the context of continuing education and clinical practice within the current healthcare system and Australian community
3 Method
A systematic qualitative approach was required to explore the multicultural aspects of nurse education. A range of different perspectives were collected to discern current concepts of culture and levels of alertness to cultural diversity.
3.1 Phase I: Review of the literature
An extensive review of the international literature was undertaken to provide a background to issues of Nursing Education in Multicultural Context. The purpose of the review was two-fold: to determine details of historical and theoretical contributions to culture and diversity in nursing and education; and to establish the broadest context of study in this area. The international literature is used as a framework against which the Australian experience, as reported in this project, is compared and contrasted.
3.2 Phase II: Project reference group
The project was developed under the auspices of the Multicultural Health Program (MHP) established at the University of New South Wales in Sydney by Maurice Eisenbruch, Professor of Multicultural Health. A project reference group was convened to contribute context specific advice and direction by individuals of distinction in specialist areas of nursing, management and education. This reference group supported the approach to reviewing the multicultural context of nurse education from a range of perspectives (recent nursing graduates, organization or faculty, educators, managers, workforce) and assisted by sharing their perceptions of the current position, contextual interpretation of background literature and aspects of data collection such as organising interviews and focus groups.
3.3 Phase III: Survey of Universities and Colleges
The Deans of thirty-four Faculties and Colleges currently offering undergraduate or postgraduate nursing education and training were contacted via email and asked to complete a survey on the multicultural context of nursing education. The organizations and their spokespersons are given in Appendix A. The survey focused on four major themes (below) and invited spokespersons to outline the activities of their Faculty or College in regard to education or research around culture or diversity. Spokespersons were also invited to comment upon the possible implications of nursing education in multicultural context for their institution.
3.3.1 Survey Themes
1. What needs to be done?
Cultural issues identified as relevant to nursing education
Principles guiding the development of cultural competence in nursing curricula
2. What is being done?
Details of courses currently offered (e.g. transcultural nursing, complementary medicine, qualitative research methods, ethnography) in which cultural issues are included
Impact of the current diversity in nursing students (e.g. cultural background, international students) on nursing education
3. What is not being done?
Gaps and constraints in curriculum transformation for cultural competence, and possible ways to overcome these
Areas where the nursing curriculum falls short of preparing nurses for nursing practice in multicultural Australia
4. How to respond?
Attracting students from culturally diverse backgrounds to nursing
Encouraging commitment to life-long learning including diversity and cultural aspects of nursing for those already engaged in nursing
5. Implications for nursing research and development
6. Implications for your Faculty and University
Responses were requested by return email. Following return, responses were coded by two independent coders and were collated according to dominant and recurring themes using the framework provided by the questions above.
Survey responses were received by return email from 27 of the 34 universities and colleges offering undergraduate and postgraduate nursing education and training in Australia (79 per cent response rate).
3.4 Phase IV: In-depth interviews and focus groups
Seven universities were selected for an in-depth telephone interview. The purpose of this interview was to elicit a greater depth of understanding of survey responses.
The following probes were used for the interview:
Do you have a current policy or statement on the cultural aspects of educational requirements for nursing students?
Are you aware of EAPS (Ethnic Affairs Priority Statement) and if so, have you incorporated it into you policy or statement? (NSW only)
Do you regularly report through your Equity/Diversity Unit?
What sort of theoretical underpinnings do you or your School draw upon in your curriculum?
How does what we have discussed (or what you have sent us on the email) relate to the research interests/publications of your Faculty?
Do any of the faculty have a research interest in multicultural nursing?
Do you believe this interest has impacted upon their teaching?
Do you believe this interest has impacted upon their colleagues?
How is this impact felt…is it mainly on course content or do you feel it has had a real impact on process?
Do you feel the university has a good understanding of the cultural profile of the population within its catchment?
Is this reflected within your student body?
At which rural/remote institutions or hospitals do your nursing students attend clinical placements?
How does your School’s approach to diversity/multicultural health relate to other work in your university, e.g. Faculty of Medicine, Social Work?
At all times, the interviewer sought clarification of meaning when the words ‘multicultural’, ‘culture’, ‘diversity’, ‘ethnicity’ or ‘cultural competence’ were used by the spokesperson. This was to avoid assumption or judgement about meanings or context used by the interviewee. Spokespersons were also invited to give examples of models of multicultural education they were aware of or had experience with. Representatives from the professional nursing colleges (The Royal College of Nursing, Australia and The New South Wales College of Nursing) were also interviewed (Appendix A).
In addition, the project reference group had identified a number of local programs demonstrating innovative approaches to multicultural health within a clinical practice application or within curriculum development. A project team member interviewed key informants from these programs and details of their models were discussed. Recent graduates’ perspectives on issues of nurse education in a multicultural context within their undergraduate training was explored through two focus group sessions held in Sydney.
3.5 Phase V: Collection of supporting data
The Australian Nursing Council Incorporated (ANCI) issues a reference for core competency standards for the Registered Nurse in Australia and, as these form a basis for curriculum development in nurse education, those referring to aspects of culture are discussed. Policy documents relating to culture or diversity in nurse education that had been prepared by professional Nursing Boards or Colleges were requested from representatives of these organizations (Appendix A) and the content reviewed. Although Nursing Registration Boards within Australia do not routinely collect data on country of birth, the NSW New Graduate Recruitment Consortium located in Sydney does collect some information on the languages spoken and background of nursing graduates seeking employment within New South Wales. The Consortium provides a placement service to around 100 hospitals in NSW and receives applications from approximately two-thirds of NSW nursing graduates each year. These data are reported in reference to the diversity of the Australian nurse and are contained in Appendix C.
3.6 Phase VI: Collation of responses
Responses from all groups (surveys, interviews and focus groups) were collated according to dominant themes and reviewed by the Reference Group.
3.7 Phase VII: Dissemination of results
The outcome is a discussion paper that will contribute a comprehensive summary of Nurse Education in Multicultural Context to the current Review of Nurse Education and to the publication of a final project report by DETYA. The Multicultural Health Program at University of New South Wales will also disseminate through the Faculty of Medicine and, in due course, through networks of other Faculties of Medicine around Australia.
Any comments or queries should be sent to: highered@dest.gov.au
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last updated on Tuesday, 04 December 2001
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